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Dumping SyndromePhase 2NCT01637272

Phase II Study Evaluating Efficacy, Safety and Pharmacokinetics of Pasireotide in Patients With Dumping Syndrome

A Phase 2 study testing SOM230 in people with Dumping Syndrome, run by Novartis Pharmaceuticals at 17 sites in 5 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

multi-center, phase II study evaluating efficacy, safety and pharmacokinetics of pasireotide in patients with dumping syndrome Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Dumping Syndrome
What is being tested?
SOM230
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
43 participants
Where
17 sitesin 5 countries
Study dates
8 Jan 2013to 7 Aug 2015
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female patients ≥ 18 years of age.
  • Post-gastric or esophageal bypass surgery, matching one of the criteria below:
  • Bariatric surgery: more than 6 months before signing the informed consent
  • Esophageal cancer surgery: were disease free at study entry
  • Gastric cancer surgery: were at stage 0 or I and were disease free at study entry
  • Patient with a documented diagnosis of Dumping Syndrome defined as having:
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  • History of/or active symptoms associated with dumping syndrome (e.g. post-prandial tachycardia, bloating, diarrhea) and
  • Documented history of hypoglycemia based on either:
  • glucose <50 mg/dL or 2.8 mmol/L on a sporadic or scheduled blood analysis -or
  • glucose value <60 mg/dL or ≤ 3.3 mmol/L at 90, 120, 150 or 180 min during an OGTT
  • Patients had at least one glucose level <60 mg/dL (or ≤ 3.3 mmol/L) at 90, 120, 150 or 180 min during the 3-hour OGTT at screening.
  • Patients with esophageal cancer with a negative computed tomography (CT) or Magnetic resonance imaging (MRI) scan (neck, thoracic, and upper abdominal) and albumin
  • ≥ 3.5 g/dl at baseline.
  • Patients with gastric cancer with a negative CT or MRI scan (total abdomen).
  • Karnofsky Performance Status ≥ 60 (i.e. required occasional assistance, but was able to care for most of their personal needs)
  • Patients who received other therapies for dumping syndrome (such as acarbose, gama guar, pectin) must have stopped all treatments and had a wash out period prior to signing the informed consent (i.e. at least 2 weeks between last previous therapy and first dose of study medication in this study).
  • Patients who had provided signed written informed consent prior to study participation.

Who cannot join

  • Bariatric patients who had lap band.
  • Patients with a current diagnosis of diabetes mellitus.
  • Patients who had failed treatment with somatostatin analogues for dumping syndrome in the past.
  • Patients who had been treated with somatostatin analogues in the past, must have had an appropriate interval between the last administration of somatostatin analogues treatment and the study drug as follows
  • Octreotide sc for ≥ 72 hours
  • Octreotide LAR for ≥ 56 days (8 weeks)
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  • Lanreotide Autogel for ≥ 98 days (14 weeks)
  • Lanreotide SR ≥ 28 days (4 weeks)
  • Patients who were already treated with pasireotide.
  • Patients who had a known hypersensitivity to somatostatin analogues.
  • Patients who were receiving anti-cancer therapy (chemotherapy and/or radiotherapy).
  • Patients who had any severe and/or uncontrolled medical conditions or other conditions that could affect their participation in the study such as:
  • Patients with the presence of active or suspected acute or chronic uncontrolled infection or with a history of immunodeficiency, including a positive human immunodeficiency virus (HIV) test result (ELISA and Western blot). An HIV test was not required; however, previous medical history was reviewed.
  • Non-malignant medical illnesses that were uncontrolled or whose control may have been jeopardized by the treatment with this study treatment.
  • Life-threatening autoimmune and ischemic disorders.
  • Patients with the presence of active or suspected acute or chronic uncontrolled infection.
  • Inadequate end organ function as defined by:
  • Inadequate bone marrow function:
  • White blood cells (WBC) <2.5 x 109/L
  • Absolute neutrophil count <1.5 x 109/L
  • Platelets <100 x 109/L
  • Hemoglobin <9 g/dL
  • International normalized ratio (INR) ≥ 1.3
  • Serum creatinine >2.0 mg/dL
  • Alkaline phosphatase (ALP) >2.5 x upper limit of normal (ULN)
  • Serum total bilirubin >1.5 x ULN
  • Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) >2 x ULN
  • History of liver disease, such as cirrhosis or chronic active hepatitis B and C.
  • Presence of Hepatitis B surface antigen (HbsAg) and/ or presence of Hepatitis C antibody test (anti-Hepatitis C Virus).

Trial locations and contacts

17 sites in 5 countries.

17 sites in 5 countries

United States6 sites
  • Virginia Endocrinology Research SC

    Chesapeake, Virginia, 23321

  • Texas Tech University Health Science Center

    El Paso, Texas, 79905

  • Ximed Center for Weight Management Ximed Research

    La Jolla, California, 92037

  • Mayo Clinic - Rochester Mayo MN

    Rochester, Minnesota, 55905

  • Stanford University Medical Center SC - SOM230X2203

    Stanford, California, 94304

  • Montefiore Medical Center CLCZ696B2320

    The Bronx, New York, 10467

Other trials in United States

Belgium4 sites
  • Novartis Investigative Site

    Bruges, Belgium, 8310

  • Novartis Investigative Site

    Brussels, 1200

  • Novartis Investigative Site

    Ghent, 9000

  • Novartis Investigative Site

    Leuven, 3000

Other trials in Belgium

France3 sites
  • Novartis Investigative Site

    Paris, 75651

  • Novartis Investigative Site

    Pessac, 33604

  • Novartis Investigative Site

    Pierre-Bénite, 69495

Other trials in France

Germany2 sites
  • Novartis Investigative Site

    Hamburg, 20246

  • Novartis Investigative Site

    Würzburg, 97080

Other trials in Germany

Netherlands2 sites
  • Novartis Investigative Site

    Groningen, 9713 GZ

  • Novartis Investigative Site

    Utrecht, Netherlands, 3584CX

Other trials in Netherlands

About this study

Official title: A Multi-center, Intra-patient Dose Escalation Phase II Study to Evaluate the Preliminary Efficacy, Safety and Pharmacokinetics of Pasireotide (SOM230) Subcutaneous (s.c.) Followed by Pasireotide LAR in Patients With Dumping Syndrome

multi-center, phase II study evaluating efficacy, safety and pharmacokinetics of pasireotide in patients with dumping syndrome

Read the detailed description

43 adult patients with dumping syndrome received pasireotide s.c. during the dose escalation phase (3 months dose could be increased based on the presence of hypoglycemia during OGTT). After completing Month 3, patients were switched to pasireotide LAR for 3 months (up to Month 6). The core phase of the study was completed at the end of Month 6. Patients were allowed to enter the 6 month extension phase if they experienced benefit with pasireotide LAR treatment.

Being tested
SOM230
Keywords
Dumping syndrome, SOM230, pasireotide LAR
Medical subject headings
Dumping Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SOM230Drug

    Also called pasireotide

    Pasireotide (SOM230) sc injection was provided as solution for injection in individual 1-point-cut 1 mL ampule, containing nominally 200 μg of pasireotide (as free base). Doses: 50, 100, 150 and 200 μg. Pasireotide im LAR depot injection was provided as micro particles powder in vials containing nominally 10, 20, 40 \& 60 mg of pasireotide (as free base) \& solvent for suspension for injection in ampules for the reconstitution of the LAR micro particles. Doses: 10, 20, 30, 40 or 60 mg

Study groups in NCT01637272
Study groupRoleWhat they receive
SOM230ExperimentalSubjects with dumping syndrome treated with pasireotide
Receives: Drug: SOM230

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Response Rate in Plasma Glucose Level

    Response rate is defined as percentage of patients with no glucose values < 60 mg/dL at 90,120, 150 and 180 min during the Oral Glucose Tolerance Test (OGTT) at the end of s.c. dose escalation phase

    Measured: at Month 3 (M3)

Secondary outcomes (18)
  1. Response Rate in Plasma Glucose Level

    Response rate is defined as percentage of patients with no glucose values < 60 mg/dL at 90,120, 150 and 180 min during the Oral Glucose Tolerance Test (OGTT) at the end of 6 months (end of LAR/Core phase) and at the end of 12 months (extension phase)

    Measured: at Month 6 (M6), Month 12 (M12)

  2. Response Rate in Pulse Rate

    Pulse rate was defined as percentage of patients with change in pulse rate >=10 bpm from pre-OGTT to 30 minutes post OGTT.

    Measured: at baseline, M3, M6, M12

  3. Response Rate in Hematocrit Levels

    Percentage of patients with change in hematocrit >= 3% from pre-OGTT to 30 minutes post OGTT.

    Measured: M3, M6, M12

  4. Insulin Levels During OGTT

    Absolute insulin levels at the end of M3, M6, M12

    Measured: M3, M6, M12

  5. Glucagon Levels During OGTT

    Absolute glucagon levels at the end of Months 3, 6 \& 12

    Measured: M3, M6, M12

  6. Glucagon-like Peptide 1 (GLP-1) Levels During OGTT

    Absolute Glucagon-like peptide 1 (GLP-1) levels at the end of at the end of Months 3, 6 and 12 at different time points.

    Measured: M3, M6, M12

  7. Gastric Inhibitory Polypeptide (GIP) Levels at During OGTT

    Absolute Gastric Inhibitory Polypeptide (GIP) levels at the end of Months 3, 6 and 12 at different time points.

    Measured: M3, M6, M12

  8. Health-related Quality of Live (HRQoL) Short Form- 36 (SF-36) Score(s)

    Absolute HRQoL SF-36 Scores at end of the Months 3, 6 and 12 from s.c. baseline. SF-36, a 36-Item Short Form Health Survey (SF-36) is a set of generic, coherent, and easily administered quality-of-life measures. These measures rely upon patient self-reporting. Items are scored so that a high score defines a more favorable health state. In addition, each item is scored on a 0 to 100 range so that the lowest and highest possible scores are 0 and 100, respectively.

    Measured: M3, M6, M12

  9. Dumping Severity Score (DSS) at the End of Months 3, 6 and 8

    Absolute Dumping Severity Score (DSS) scores at end of M3, M6 \& M8. At study start patients were assessed using DSS (older version of DSQ); however after the implementation of protocol amendment 2, all patients were expected to use DSQ. No results available for M12 as last patient that answered the DSS was at M8. DSS = disease-specific patient (Pt.) reported outcome (PRO) questionnaire uses a 4-point Likert scale (0, absent; 1, mild; 2, relevant; 3, severe; 4) to ask Pt. to evaluate intensity of early dumping symptoms (within 30 minutes (<30 minutes) after food ingestion). The questionnaire also evaluates 65 late dumping symptoms (more than 1.5 hours (>90 minutes) after food ingestion). Early \& late dumping score calculated by adding the scores of the respective questions. Cumulative dumping score is obtained by adding early \& late scores. DSS Range (min (absent) - max (severe)): Early dumping: 0-24; Late Dumping: 0-18; Cumulative: 0-42. Lower scores represent a better outcome.

    Measured: M3, M6, M8

  10. Dumping Score Questionnaire (DSQ) at the End of Months 3, 6 and 12

    Absolute Dumping Score Questionnaire (DSQ) scores at end of Months 3, 6 \& 12 from s.c. baseline. DSQ = disease-specific PRO scale. The questionnaire uses a 5-point Likert scale (0, none; 1, mild; 2, moderate; 3, severe; 4, very severe) to ask Pt. to evaluate intensity of 10 early dumping symptoms (within 30 minutes (<30 minutes) after food ingestion). The questionnaire also evaluates 5 late dumping symptoms (more than 1.5 hours (>90 minutes) after food ingestion). Early \& late dumping score calculated by adding the scores of respective questions. A cumulative dumping score is obtained by adding early \& late scores. At study start patients were assessed using DSS (older version of DSQ); however after the implementation of protocol amendment 2, all patients used DSQ. DSQ Range: (min (None) - max (Very severe)): Early dumping: 0-40; Late Dumping: 0-20; Cumulative: 0-60. Lower scores represent a better outcome.

    Measured: M3, M6, M12

  11. Patient Global Assessment at the End of Months 3, 6 and 12

    Treatment with pasireotide LAR (both early and late dumping scores), was assessed by patient global assessment. Patient Global Assessment served as an additional approach to symptom based measurement by DSQ. It incorporated a patient global assessment question: "Considering all the ways that your disease affects you, rate how you are feeling during the last 7 days compared with your situation before starting the study" .Patients Global Assessment was measured utilizing a 7 point scale (from 1=a lot worse to 7= a lot better).

    Measured: M3, M6, M12

  12. Plasma Pharmacokinetic (PK) Parameter of Pasireotide: Cmax, ss (Steady State) and Ctrough, ss, After s.c. Injection

    A pre-dose PK blood sample was collected before the morning pasireotide s.c. dose of 50 μg, 100 ug, 150 ug and 200 ug. OGTT was performed right after the morning s.c. dose (Time point zero); additional PK blood samples were collected at the same time points as the OGTT evaluation at 30, 60, 90, 120, 150 and 180 minutes. 'n' = number of subjects with non-missing values

    Measured: M1 to M3

  13. Plasma Pharmacokinetic (PK) Parameter of Pasireotide: AUC0-3h, ss, After s.c. Injection

    A pre-dose PK blood sample was collected before the morning pasireotide s.c. dose of 50 μg, 100 ug, 150 ug and 200 ug. OGTT was performed right after the morning s.c. dose (Time point zero); additional PK blood samples were collected at the same time points as the OGTT evaluation at 30, 60, 90, 120, 150 and 180 minutes.

    Measured: M1 to M3

  14. Plasma Pharmacokinetic (PK) Parameter of Pasireotide: Tmax, ss, After s.c. Injection

    A pre-dose PK blood sample was collected before the morning pasireotide s.c. dose of 50 μg, 100 ug, 150 ug and 200 ug. OGTT was performed right after the morning s.c. dose (Time point zero); additional PK blood samples were collected at the same time points as the OGTT evaluation at 30, 60, 90, 120, 150 and 180 minutes.

    Measured: M1 to M3

  15. Plasma PK Parameter of AUC0-3h, d21, End _inj and AUC0-3h, d28, 3rd_inj Associated With LAR (LAR Core Phase)

    Measured: M4 to M6

  16. Summary of LAR PK Parameters by Dose

    Summary of plasma PK parameter Cmax, p2 , 2nd injection and Ctrough, d28 associated with LAR injection (LAR Core phase)

    Measured: M4 to M6

  17. Pasireotide Concentrations in LAR Phase

    Summary of pasireotide concentrations following monthly i.m. injections of pasireotide LAR by incident dose (LAR Pharmacokinetic set)

    Measured: M7 to M12

  18. LAR PK Parameter: Ctrough - at Steady State (ss) by Dose

    In the LAR treatment phase, monthly injections of pasireotide LAR 10, 20, 30 and 40 mg were given to participants and trough concentration at steady state (Ctrough,ss) were obtained but due to only 1 participant in the 40mg arm, standard deviation could not be calculated.

    Measured: M4 to M12

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jul 2012 (estimated)
  2. Study start8 Jan 2013
  3. Primary completion7 Aug 2015
  4. Study completion7 Aug 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Single group
Masking
None (open label)
Enrolment
43 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01637272
Sponsor's protocol ID
CSOM230X2203
Other IDs
2012-001534-34
Status last verified
Mar 2017
First submitted
9 May 2012
Last updated
10 May 2017
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing SOM230 in people with Dumping Syndrome, run by Novartis Pharmaceuticals at 17 sites in 5 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 17 inclusion and 29 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 May 2017. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 17 sites in United States, Belgium, France, Germany, Netherlands. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 10 May 2017). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Response Rate in Plasma Glucose Level (time frame: at Month 3 (M3)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 May 2017.

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